Deck 33: Alterations of Pulmonary Function

Question 1

There is no specific treatment for silicosis, although corticosteroids may produce some improvement.

Answer 1

True

Question 2

A pulmonary artery pressure of 23 mm Hg is normal.

Answer 2

False

Question 3

Hypoxemia is the reduced oxygenation of tissue cells, whereas hypoxia is the reduced oxygenation of arterial blood.

Answer 3

True

Question 4

Persons with an I-antiprotease deficiency are predisposed to asthma.

Question 5

Respirations that are characterized by alternating periods of deep and shallow breathing are a result of:

A)decreased blood flow to the medulla oblongata.
B)increased PaCO₂, decreased pH, and decreased PaO₂.
C)stimulation of stretch or J-receptors.
D)fatigue of the intercostal muscles and diaphragm.

Question 6

_____ is the selective bulbous enlargement of the distal segment of a digit and is commonly associated with diseases that interfere with oxygenation of the blood.

A)Edema
B)Clubbing
C)Angling
D)Osteoarthropathy

Question 7

With a total hemoglobin of 9 g/dl, _____ g/dl of hemoglobin must become desaturated for cyanosis to occur:

A)3
B)5
C)7
D)9

Question 8

Tuberculosis (TB) is transmitted from person to person through airborne droplets.

Question 9

_____ is generally relieved by sitting up in a forward-leaning position.

A)Hyperpnea
B)Orthopnea
C)Apnea
D)Dyspnea on exertion

Question 10

Dyspnea is not a result of:

A)decreased pH, increased PaCO₂, and decreased PaO₂.
B)decreased blood flow to the medulla oblongata.
C)stimulation of stretch or J-receptors.
D)fatigue of the intercostal muscles and diaphragm.

Question 11

Mycobacterium tuberculosis remains dormant and walled off in tubercles for life, but may be reactivated if a person's immune system is impaired.

Question 12

Kussmaul respirations may be characterized as a respiratory pattern:

A)with alternating periods of deep and shallow breathing.
B)commonly observed in pulmonary fibrosis.
C)commonly observed in chronic obstructive pulmonary disease.
D)with a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.

Question 13

Pulmonary edema and pulmonary fibrosis cause hypoxemia by:

A)creating alveolar dead space.
B)decreasing the oxygen in inspired gas.
C)creating a right-to-left shunt.
D)impairing alveolocapillary membrane diffusion.

Question 14

An abnormal ventilation-perfusion ratio is a common cause of hypoxemia.

Question 15

High altitudes may produce hypoxemia through:

A)shunting.
B)hypoventilation.
C)decreased inspired oxygen.
D)diffusion abnormalities.

Question 16

The greatest single risk factor for reactivation of tuberculosis is infection with HIV.

Question 17

Paroxysmal nocturnal dyspnea (PND) is a result of:

A)obstructed bronchi.
B)collapsed alveoli.
C)fluid in the lungs.
D)inflamed bronchioles.

Question 18

Chronic pulmonary hypertension can lead to cor pulmonale.

Question 19

Pneumoconiosis is a pneumonia caused by pneumococci.

Question 20

Which of the following is a true statement?

A)Hypoventilation causes hypocapnia.
B)Hyperventilation causes hypercapnia.
C)Hyperventilation causes hypocapnia.
D)Hyperventilation results in an increased PaCO₂.

Question 21

In _____ pleural effusion, the fluid is watery and diffuses out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure.

A)exudative
B)purulent
C)transudative
D)large

Question 22

Which statement about silicosis and asbestosis is false? Neither silicosis nor asbestosis is:

A)caused by inhalation of inorganic dust particles.
B)a type of pneumoconiosis.
C)a cause of lung cancer.
D)a cause of cellular apoptosis.

Question 23

Pulmonary edema usually begins at a pulmonary capillary wedge pressure or left atrial pressure of _____ mm Hg.

A)10
B)20
C)30
D)40

Question 24

The effect of inflammatory cytokines, tumor necrosis factor-alpha (TNF-a), and IL-1 on asthma is that they increase levels of:

A)norepinephrine, which causes bronchial smooth muscle contraction and mucus secretion.
B)acetylcholine, which causes bronchial smooth muscle contraction and mucus secretion.
C)epinephrine, which causes bronchial smooth muscle contraction and increases capillary permeability.
D)immunoglobulin G, which initiates the complement cascade and causes smooth muscle contraction and increased capillary permeability.

Question 25

The cause of pulmonary edema in ARDS is the result of increased:

A)levels of serum sodium and water.
B)capillary permeability.
C)capillary hydrostatic pressure.
D)oncotic pressure.

Question 26

Which pleural abnormality involves a site of pleural rupture that act as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration?

A)Spontaneous pneumothorax
B)Tension pneumothorax
C)Open pneumothorax
D)Secondary pneumothorax

Question 27

Which immunoglobulin may contribute to the pathophysiology of asthma?

A)IgA
B)IgE
C)IgG
D)IgM

Question 28

_____ is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.

A)Acute respiratory distress syndrome (ARDS)
B)Pneumonia
C)Pulmonary emboli
D)Acute pulmonary edema

Question 29

Which of the following is not a cause of chest wall restriction?

A)Pneumothorax
B)Severe kyphoscoliosis
C)Gross obesity
D)Neuromuscular disease

Question 30

In ARDS, alveoli and respiratory bronchioles fill with fluid as a result of the:

A)compression on the pores of Kohn, thus preventing collateral ventilation.
B)increased capillary permeability, which causes alveoli and respiratory bronchioles to fill with fluid.
C)inactivation of surfactant and the impairment of type II alveolar cells.
D)increased capillary hydrostatic pressure that forces fluid into the alveoli and respiratory bronchioles.

Question 31

Alveolar dead space is a result of:

A)pulmonary edema.
B)pulmonary emboli.
C)atelectasis.
D)pneumonia.

Question 32

The most common cause of pulmonary edema is:

A)right-sided heart failure.
B)left-sided heart failure.
C)mitral valve prolapse.
D)aortic stenosis.

Question 33

Which type of pulmonary disease requires more force to expire a volume of air?

A)Restrictive
B)Obstructive
C)Acute
D)Communicable

Question 34

In ARDS, inflammatory mediators such as proteolytic enzymes, oxygen free radicals, prostaglandins, leukotrienes, and platelet-activating factor are released by:

A)complement cascade.
B)mast cells.
C)macrophages.
D)neutrophils.

Question 35

Which inflammatory mediators are produced in asthma?

A)Neutrophil proteases, bradykinin, and histamine
B)Bradykinin, serotonin, and neutrophil proteases
C)Histamine, prostaglandins, and leukotrienes
D)Lymphokines, serotonin, and prostaglandins

Question 36

A(n) _____ is a circumscribed area of suppuration and destruction of lung parenchyma.

A)consolidation
B)cavitation
C)empyema
D)abscess

Question 37

_____ atelectasis is the collapse of lung tissue caused from the lack of collateral ventilation through the pores of Kohn.

A)Compression
B)Perfusion
C)Absorption
D)Hypoventilation

Question 38

In _____ bronchiectasis, both constrictions and dilations deform the bronchi.

A)varicose
B)symmetric
C)cylindric
D)saccular

Question 39

Clinical manifestations of inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea are indicative of:

A)chronic bronchitis.
B)emphysema.
C)pneumonia.
D)asthma.

Question 40

_____ involves an abnormally enlarged gas-exchanged system and the destruction of alveolar walls.

A)Transudative effusion
B)Emphysema
C)Exudative effusion
D)Abscess

Question 41

Which bacteria become embedded in the airway secretions in chronic bronchitis?

A)Legionella pneumophila and Chlamydia pneumoniae
B)Klebsiella pneumoniae and Pneumocystis jiroveci
C)Haemophilus influenzae and Streptococcus pneumoniae
D)Mycoplasma pneumoniae and Staphylococcus aureus

Question 42

Match the descriptions with the corresponding terms.
Pulmonary fibrosis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 43

The most common route of lower respiratory tract infection is:

A)aspiration of oropharyngeal secretions.
B)inhalation of microorganisms.
C)microorganisms spread to lung via blood.
D)poor mucus membrane protection.

Question 44

Clinical manifestations of inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy are indicative of:

A)chronic bronchitis.
B)emphysema.
C)pneumonia.
D)asthma.

Question 45

Match the descriptions with the corresponding terms.
Flail chest

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 46

Match the descriptions with the corresponding terms.
Pleural effusion

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 47

Pulmonary hypertension results from which of the following alteration?

A)Narrowed pulmonary capillaries
B)Narrowed bronchi and bronchioles
C)Destruction of alveoli
D)Ischemia of the myocardium

Question 48

Squamous cell carcinoma of the lung is best described as a tumor that:

A)causes airway obstruction and ectopic hormone production.
B)produces a productive cough and airway obstruction in addition to pneumonia and atelectasis.
C)causes pleural effusion and shortness of breath.
D)produces chest wall pain, pleural effusion, productive cough, and hemoptysis.

Question 49

Match the descriptions with the corresponding terms.
Bronchiolitis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 50

Match the descriptions with the corresponding terms.
Atelectasis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 51

Match the descriptions with the corresponding terms.
Bronchiectasis

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 52

Match the descriptions with the corresponding terms.
Aspiration

A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 53

The most successful treatment for chronic asthma begins with:

A)elimination of the causative agent.
B)broad-spectrum antibiotics.
C)drugs that reduce bronchospasm.
D)drugs that decrease airway inflammation.

Question 54

Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of:

A)chronic bronchitis.
B)emphysema.
C)pneumonia.
D)asthma.

Question 55

The progression of chronic bronchitis is best halted by:

A)regular use of bronchodilators.
B)smoking cessation.
C)postural chest drainage techniques.
D)identification of early signs of infection.

Question 56

In tuberculosis, the body walls off the bacilli in a tubercle by stimulating:

A)macrophages that release TNF-a.
B)phagocytosis by neutrophils and eosinophils.
C)formation of immunoglobulin G to initiate the complement cascade.
D)apoptotic infected macrophages that activate cytotoxic T cells.

Question 57

Smoking contributes to emphysema by:

A)interrupting the production of elastase.
B)destroying cilia in the bronchi.
C)reducing endogenous antiproteases.
D)creating hyperplasia of submucosal glands.

Question 58

Clinical manifestations of pulmonary hypertension include:

A)systemic blood pressure greater than 130/90.
B)productive cough and rhonchi bilaterally.
C)dyspnea on exertion and paroxysmal nocturnal dyspnea.
D)peripheral edema and jugular venous distention.

Question 59

Clinical manifestations of decreased exercise tolerance, wheezing, shortness of breath, and productive cough are indicative of:

A)chronic bronchitis.
B)emphysema.
C)pneumonia.
D)asthma.

Question 60

Match the descriptions with the corresponding terms.
Pneumothorax

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 61

Match the descriptions with the corresponding terms.
Exudative effusion

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures

Question 62

Match the descriptions with the corresponding terms.
Empyema

A)Accumulation of air in pleural space
B)Pus in the pleural space
C)Accumulation of fluid in the pleural space
D)Inflammation of the pleura
E)Result of rib or sternal fractures